Laserfiche WebLink
LIIWII VlllIluitLMi >iwv«ia>>a ■ <br />TEMPORARY FOOD VENDOR’S APPLICATION <br />I.Name of Event: <br />Phone: <br />List food to be sold or given to the public: <br />i <br />the hot and cold holding of potentially hazardous <br />meats, tamales, cooked beans, rice, <br />vegetables, potato salad, eggs, and dairy products. <br />5 <br />own jumquih <br />COUNTY <br /> Other (specify):__—------------ <br />only operations not required to provide enclosed booths <br />868 E. Hazelton Avenue | Stockton. California 952051 T 209 468-3420 | F 209 464-0,38 | www.ejgojno^eh^ <br />HD 16-02 r\ Ka‘n <br />Y01/2025 I \ I <br />HyACh C A <?5~3~76 <br /> <br />Lhtlu't fb&J "T <br />Note: The only operations not required to prov.de enclosed booths are those which sen beverages from <br />approved dispensers, or prepackaged foods from approved sources. <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the foltowing methods: <br />pl Approved bottled water. <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): --------------------------------—=—-------- <br />Electricity is provided for my booth's use: t^Yes l_| No <br />I am providing an accurate probe thermometer to measure <br />I a^raviding ^“Xv^mte^atorSonWl for me hot holding of all potentially hazardous foods above <br />135°F: . <br /> Camp stove l&Stemo & hotel trays <br /> Double steamer O Steam table & lids <br /> Electric stove top O Other (specify) <br />Note: Examples of potentially hazardous food include: <br />I am providma food that is NOT prepared at home: ^Yes No <br /> If <br />dust and the public) <br />g A booth with walls and ceiling constructed of either wood, canvas, plastic, similar rrvrtenalfly <br />screening completely enclosing open food areas. It will also have a smooth and cteanabte fbor (concrete <br />asphalt, dean tarps and smooth wood are acceptable) and constructed to separate food and food preparaton <br />areas from the public. <br />food vendors (both for profit and non-profit) are required Io return a signed and completed copy of this checklist to <br />‘ festival coordinator three (3) weeks prior to this event. / <MhVr<i >1 JbiI( AV-k Date(s): ------ <br />The following is information about my organization/busincss: <br />Name of organizalion/business: B <br />Address: 3>3iO N TY^ <br />^7'q Li I